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Topic: BCBS of FL for VSG (vertical sleeve gastrectomy)
Anyone have BCBS of FL and had the VSG? My question is primarily for those with a BMI of 50 or higher. I had questions if BCBS of FL would cover the VSG with the patient having a higher BMI. Any ideas or thoughts? I have already called them and they gave me the patient information but said the surgeon would get more info when he called in to "pre certify" me. Just want the heads up.
Ginger
Ginger
Topic: Will meidcare pay for a revision in California
I have medical and medicare. I need to find out if medicare will pay for a revision from lapband to something else, anything else. I really need to looses the weight. Someone please lead me in the right direction.
lapband 7/08 revised to rny 7/11
Topic: RE: Still waiting for approval for surg, but BCBSNC has paid for all testing
APPROVED! Surgery scheduled April 26th.
Carolyn
Topic: RE: Insurance denial reasons? BCBS of FL in particular.
Hi Stacy,
Wow, I am so sorry to hear about your struggles!! So then it was a total exclusion on the part of the insurance co for your particular employer?? Wow!! So where does that leave you now in hopes of having surgery? Are you able to self pay (although quite costly) or are you able to get under different insurance (perhaps yours husbands or ??)?
Actually after having this insurance for a year now, I got a bill from a provider I had gone to and it showed my small balance owing after insurance had paid a portion. In the top right corner I noticed it said BCBS of SC was billed. So we don't even have BCBS of FL!!! HA! Who knew? When I called the insurance company (from the back of my card) they had read to me all the things I needed to do in order to get approval... and I've done them and we're finally ready to submit to the insurance company (I haven't been denied or approved). My husband (whom we have insurance through) has been at this job for one year now but the insurance co. requires insurance coverage for 1 year before any major expense (including bariatrics surgery) to be paid. So I have to wait until 4/8/11 to submit all my paperwork. I have an appointment on 4/11/11 at 9am to sit down with the insurance girl at the surgen's office and go over everything to make sure we have it all together and then we'll submit that day if everything looks good. I'm assuming it will all be in order and we'll be able to submit then.
I think it's crazy how every insurance company can be so different with what they require and what they don't require but then you add in how each individual employer can pick and choose what THEY want out of those ins. companies. CRAZY!!
I really appreciate your insight and I hope you have a way to achieve your goal and your destiny. Good luck!!
Ginger
Wow, I am so sorry to hear about your struggles!! So then it was a total exclusion on the part of the insurance co for your particular employer?? Wow!! So where does that leave you now in hopes of having surgery? Are you able to self pay (although quite costly) or are you able to get under different insurance (perhaps yours husbands or ??)?
Actually after having this insurance for a year now, I got a bill from a provider I had gone to and it showed my small balance owing after insurance had paid a portion. In the top right corner I noticed it said BCBS of SC was billed. So we don't even have BCBS of FL!!! HA! Who knew? When I called the insurance company (from the back of my card) they had read to me all the things I needed to do in order to get approval... and I've done them and we're finally ready to submit to the insurance company (I haven't been denied or approved). My husband (whom we have insurance through) has been at this job for one year now but the insurance co. requires insurance coverage for 1 year before any major expense (including bariatrics surgery) to be paid. So I have to wait until 4/8/11 to submit all my paperwork. I have an appointment on 4/11/11 at 9am to sit down with the insurance girl at the surgen's office and go over everything to make sure we have it all together and then we'll submit that day if everything looks good. I'm assuming it will all be in order and we'll be able to submit then.
I think it's crazy how every insurance company can be so different with what they require and what they don't require but then you add in how each individual employer can pick and choose what THEY want out of those ins. companies. CRAZY!!
I really appreciate your insight and I hope you have a way to achieve your goal and your destiny. Good luck!!
Ginger
Topic: RE: Insurance Help! Post Self-Pay VSG
With almost every carrier, it is an automatic denial. There are options in almost every state though that can help you get coverage. Many states already have what's called a risk pool that's basically coverage for what most carriers consider "Uninsurable because of high risk for expense." There are also some really good options available now in what's called scheduled benefit plans for health coverage.
In no case, should you not report your procedure or preex conditions because they will find out sooner or later and the results of that can be devastating ranging from repayment of the monies the carrier paid to legal civil action to criminal prosecution.
If you would like, i can refer you to someone in your area who can help review your situation, or I would love to help you personally with finding the best carrier and coverage options you have available for your situation and area. My email is [email protected] and my skype is myrl lawrence.
Best Regards,
Myrlio
Topic: RE: Insurance????
Hey, not sure what state you are in, but try BCBS. I am in NC and I called BCBSofNC and talked to a rep and the cover it. I also checked their website. I have CIGNA thru my hubsband's job but BCBS had plans that may work. Good Luck
Topic: RE: Still waiting for approval for surg, but BCBSNC has paid for all testing
Good luck! All will work out.
Topic: RE: Financing?
Hey, I am not paying out of pocket but have you tried appyling for a personal loan with a bank or lending company (Citifinancial or a small town lender,)? If all else fails that may be an avenue to try. Good luck!
Topic: RE: getting new insurance -best one for someone who is obese? (not seeking WLS at this time)
Hi Nia,
There are options, but unfortunately most of them don't include traditional major medical coverage. There are a ton of variables involved in deciding what's available for you, including height, weight, bmi, other medical issues, etc. if you don't have a group health plan available through an employer.
Your best option is to find an agent that specializes in health coverage and carries a broad range of companies and do a complete review of your history and needs, as well as the coverage availability in Arizona. I have a number of resources available and would love to be able to help you find an appropriate plan. Feel free to contact me and I can either help you personally, or I can find you an agent locally that specializes in this area.
You may contact me by email at [email protected] or by skype, Myrl Lawrence.
Good luck in your search,
Myrlio in Arkansas
PS. I am also writing an article for examiner.com on exactly this subject and would love to have you respond to it. The subject title is, "A personal invitation survey". Thanks in advance.
There are options, but unfortunately most of them don't include traditional major medical coverage. There are a ton of variables involved in deciding what's available for you, including height, weight, bmi, other medical issues, etc. if you don't have a group health plan available through an employer.
Your best option is to find an agent that specializes in health coverage and carries a broad range of companies and do a complete review of your history and needs, as well as the coverage availability in Arizona. I have a number of resources available and would love to be able to help you find an appropriate plan. Feel free to contact me and I can either help you personally, or I can find you an agent locally that specializes in this area.
You may contact me by email at [email protected] or by skype, Myrl Lawrence.
Good luck in your search,
Myrlio in Arkansas
PS. I am also writing an article for examiner.com on exactly this subject and would love to have you respond to it. The subject title is, "A personal invitation survey". Thanks in advance.
Topic: RE: The Sleeve and Medicare
<----The friend lol
That really does suck about Medicare, I don't understand why they won't cover it. **sigh**
That really does suck about Medicare, I don't understand why they won't cover it. **sigh**
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